Healthcare Provider Details

I. General information

NPI: 1245658855
Provider Name (Legal Business Name): IGOR SUNJIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 MEASE DR STE 202
SAFETY HARBOR FL
34695-6604
US

IV. Provider business mailing address

455 PINELLAS ST STE 400
CLEARWATER FL
33756-3356
US

V. Phone/Fax

Practice location:
  • Phone: 727-725-6246
  • Fax: 727-726-5865
Mailing address:
  • Phone: 727-445-1992
  • Fax: 727-445-1993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME135920
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: